Can Children Have Cataracts?
You’ve heard that cataracts can cause vision loss and blindness in the elderly, but can cataracts affect your child too? The answer may surprise you…
Most of us look at cataracts as something that happens to our eyes as we age — a disease of the elderly. Age-related cataracts are, in fact, the most common type of cataracts.
However, cataracts can also affect infants and children. In fact, approximately 3 out of 10,000 children have a cataract. Children may be born with a cataract (congenital) or develop one later (acquired), and the cataract may be in one eye (unilateral) or in both eyes (bilateral).
Mild cases of cataracts in infants and children often appear with no symptoms, delaying the diagnosis for years. But certain symptoms can act as a red flag for parents. If you’re concerned about your child’s eyes or vision, watch for a lack of reaction to light, strabismus (when one eye turns in or out), a failure to notice toys or faces, and other developmental delays.
What Causes Pediatric Cataracts?
Pediatric cataracts often occur due to abnormal lens development during pregnancy. Cataracts can be genetic or they can occur spontaneously. Lens malformations that occur in conjunction with other ocular or systemic findings are often the result of a genetic or metabolic problem. These cataracts may be present at birth or may develop during childhood.
An infant or young child with an untreated cataract is at risk of having partial or total vision loss. This can happen when the cataract clouds the lens during the critical developmental time and blocks light from getting to the retina (the back of the eye). The retina sends visual information to the brain and the eye and brain work together to learn to see. If the retina cannot send the visual information to the brain, and the cataract is not removed on time, the brain may never learn to see.
Do All Cataracts in Babies and Children Need to Be Removed?
No. Some cataracts are small and/or off-center in the lens. These cataracts do not need to be removed because vision develops normally, even if the cataract is left in place. But you should always check with your eye doctor to determine the best course of action for your child.
When Should My Child Have Cataract Surgery?
Babies and children with cataracts require highly specialized care, and it is recommended that you see a pediatric ophthalmologist to determine the course of action. There are methods of treating cataracts without surgery, but sometimes surgery is necessary.
Less severe cataracts may initially be treated with patching therapy, dilating eye drops and/or glasses.
Opinions vary about when cataract surgery should be performed on an infant because of concerns about complications such as the development of high intraocular eye pressure (IOP) that could lead to secondary glaucoma.
High IOP can occur if cataract surgery damages the fluid outflow structure (trabecular meshwork) inside the eye. In addition, the use of anesthesia for surgery involving very young infants can be cause for safety concerns.
On the other hand, cataract surgery may need to be performed as soon as possible to ensure that vision is clear enough to allow normal development of your baby’s vision system. Some experts say the optimal time to intervene and remove a visually significant congenital cataract from an infant’s eye is between the age of six weeks and three months.
If your baby has a congenital cataract, discuss any concerns you have about timing of cataract surgery with your ophthalmologist or eye surgeon.